Eating and drinking problems
People often have problems eating and drinking when they have a terminal illness or at the end of their life. You might have less of an appetite or find that things taste different than before.
On this page:
Changes in eating and drinking
Eating and drinking are a big part of life for many people. As well as giving us the nutrition we need, food and drink can be enjoyable and comforting. Sharing meals is a way to connect with family and friends.
Your illness or treatment might change the way you eat and drink, including:
- changes in taste and smell – this can make some foods seem less appealing than before
- loss of appetite
- mouth problems
- feeling sick and vomiting
- constipation
- difficulty swallowing – this can be caused by illnesses such as head and neck cancer, motor neurone disease and dementia
- weakness and fatigue – this can make it harder to cook and prepare meals for yourself
- depression, anxiety or stress – this can lower your appetite
- losing interest in eating and drinking in the last few days of life as the body slows down.
Not being able to eat and drink in the same way as before can cause problems, such as losing weight and feeling tired. It can also be upsetting to miss out on sharing meals with friends and family.
Practical tips for eating and drinking
If you have a low appetite or changes in taste, the following tips might help:
- Try eating small meals or snacks throughout the day instead of having large meals.
- If you have more energy at a certain time of day, plan to have your meals then.
- Eat foods that you want to eat – your favourites might change over time.
- Adding foods such as extra cheese, cream, fats and oils can help you to get lots of energy even if you cannot eat big portions.
- Make sure you're sitting upright in bed or a chair when you eat.
- Taking good care of your mouth can make it easier to eat and drink.
Getting support with eating and drinking
If you're feeling sick or have a sore mouth, speak to your doctor. They might give you medicines to help. Also tell them if you find it hard to swallow. They can arrange for you to see a speech and language therapist, who can help you to eat and drink safely.
Talk to a dietitian if you're struggling to eat because of low appetite or changes to your taste and smell, you can talk to a dietitian. They can help you plan your diet, taking into account what you like and do not like.
Find a local dietitian on the British Dietetic Association website.
If you feel anxious or depressedanxious or depressed, speak to someone you trust. This could be your nurse, doctor, counsellor or psychologist, if you have one. They can help you to talk about your thoughts and feelings, including any worries you have about eating and drinking.
Read more about psychological therapies.
If you cannot go shopping or make your own meals, you could ask a friend or family member to help. You can also get shopping or meals delivered to your home. Your local council might do this for you. They might also be able to help with other types of social care and support.
See more about getting social care and support.
Assisted eating and drinking
Some people will need extra help with eating and drinking. For example, you might need supplements or pieces of equipment to make sure you get enough to eat and drink. There are lots of options that might help you.
- Extra snacks or special drinks that have lots of energy (calories). They can help you get plenty of nutrition without having to eat big portions. If you need them, your doctor can prescribe them for you.
- Enteral feeding – this is when you are fed a special type of liquid food directly into your stomach through a tube.
- Parenteral feeding – this is when you are given fluid containing nutrients through a vein.
- Subcutaneous fluids – this is when you are given fluids into your body just below your skin.
Enteral feeding
Enteral feeding is sometimes called tube feeding. It is when you are given a special type of liquid food directly into your stomach through a tube. This can be done in two different ways:
A nasogastric tube (NG tube) is inserted through one of your nostrils and then down into your stomach.
A gastrostomy tube is inserted through your abdomen (tummy) into your stomach or intestine (gut). You will need to have a small operation for this.
You can have enteral feeding at home. A nurse or another health professional will visit you to make sure it is working properly. You will need extra equipment and you or your carer will need to be trained to use it.
Tube feeding is not suitable for everyone. Sometimes the benefits of tube feeding don't outweigh the risks. But it can be helpful for people with eating and drinking problems that won't get better with any other treatment.
The myTube website has videos for people with motor neurone disease who are thinking about having enteral feeding. It could be useful for people with other illnesses too.
Parenteral feeding
Parenteral feeding is when a special type of liquid food is given through a vein (intravenously). You will usually have one tube inserted into a vein. This tube can then be used for liquid food, fluids and medicines. You will need a short procedure for this, but you will not need an anaesthetic. Parenteral feeding is rarely used at a person's home but might be used in a hospice, hospitals or care homes.
Subcutaneous fluids
Subcutaneous fluids are fluids are given through a drip into a small needle or cannula under your skin. This is sometimes used when someone cannot drink to keep themselves hydrated.
Making decisions about eating and drinking
It can be hard to decide if you want to have enteral or parenteral feeding. Try to get as much information as you can before you decide. If you're not sure or you have questions about it, talk to your doctor or nurse.
View a tool that can help you make a decision about using a gastronomy tube.
You might be less able to make decisions about your care over time. Some people find it helpful to think about what kind of support they would like ahead of time. Making your wishes known in advance can help to make sure you get the care and treatment you want. For example, you might want to say if you would want tube feeding or not.
Read more about making decisions about care in advance.
Last weeks and days of life
It's very common for people become less interested in food in the last few weeks and days of their life. This is normal. As the body becomes weaker and slows down, people need less energy. It's normal to find it harder to eat by yourself as well.
This can be difficult to come to terms with. You might feel upset or worried if you cannot or do not want to eat. It might also be difficult for your family or friends. Providing food for our loved ones is a big part of showing that we care for them. Family and friends often want to continue doing this and worry that their loved one might be hungry or thirsty.
Find out more about eating and drinking less at the end of life.
How friends and family can help
Family and friends can support you by having your favourite foods and drinks ready if you do want them. But they should not pressure you into eating and drinking. It may help to read about what to expect in the last weeks and days.
Family and friends often ask if their loved one can have artificial hydration and nutrition. For example, tube feeding or subcutaneous fluids. For some people, this is an option. But for other people it is not. This might be because of their condition, or because it might not help them live longer or make them more comfortable.
Speak to a doctor or nurse about this. They will be able to give you advice about your specific situation. You can also find out more about eating and drinking less at the end of life.
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About this information
This information is not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.
